Robotic Excision of Atrial Myxoma

Schilling, J.; Engel, Amy M.; Hassan, Mohammed; Smith, FredA.A.

doi:10.1111/j.1540-8191.2012.01478.x

Cited by 37 publications

(34 citation statements)

References 28 publications

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“…The safety and efficacy of minimally invasive cardiac tumor resection has been confirmed in previous studies for select patients [15,16]. In our study, robotic-assisted procedures and mini-thoracotomy procedures of the left atrial myxoma resection had no significant differences in operative parameters such as cross clamp time and operative duration compared with a conventional procedure.…”

Section: Discussionsupporting

confidence: 83%

Surgical Experience of Primary Cardiac Tumor: Single-Institution 23-Year Report

Gao

2017

Med Sci Monit

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Background:Primary cardiac tumors are rare but have favorable surgical prognosis. Previous studies have been small series studies with limited surgical approaches. To date, few studies have examined the clinical features associated with different surgical procedures. Material/Methods:In a search of the cardiovascular surgery database of our institution, we retrospectively identified 225 patients who had cardiac tumor resection from January 1993 to May 2016. The patients' clinical characteristics and operation information were reviewed, and the operation parameters, postoperative complications, and short-term prognosis among robotic, mini-thoracotomy, and conventional procedures in our center were compared. Results:A total of 228 operations were performed, including 156 traditional open surgeries (68.4%), 60 robotically assisted neoplasm resections (26.3%), and 12 mini-thoracotomy procedures (5.3%). Among 232 lesions, myxoma (94.8%) was the most common neoplasm, and the remainders were fibroma (1.3%) and lipoma (0.9%). Operative complications occurred in 36 patients (15.8%). Arrhythmia (8.8%) was the first common complication, and delayed mechanical ventilation (4.8%) ranked second. The overall risk of recurrence of myxoma was 2.7%. The cardiopulmonary bypass (CPB) time in the mini-thoracotomy group was longer than in the robotic group (p=0.034) and the conventional group (p=0.002). There were no significant differences in cross clamp time (p=0.266) or complications (p=0.835) among the three groups. The in-hospital survival rate was 100% in all patients. There were no significant differences in main adverse events among the three groups at six-month follow-up (p=0.285). Conclusions:Prognosis for cardiac neoplasm surgical resection is favorable for primary cardiac tumors. The minimally invasive surgery of cardiac tumor resection can be an alternative to conventional operations in selected patients.

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Section: Discussionsupporting

confidence: 83%

Surgical Experience of Primary Cardiac Tumor: Single-Institution 23-Year Report

Gao

2017

Med Sci Monit

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“…Shorter operative times with robotically assisted resection rather than tumour removal through sternotomy have been demonstrated. 48 Other surgical procedures Robotically assisted approaches have been described for suturing a graft to a descending aorta anastomosis in placement of an apicoaortic conduit for aortic valve stenosis. 45 In addition, successful robotically assisted endoscopic unroofing of a myocardial bridge has also been reported.…”

Section: Cabg Surgerymentioning

confidence: 99%

Robotic technology in cardiovascular medicine

et al. 2014

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Robotic technology has been used in cardiovascular medicine since the late 1990s. Interventional cardiology, electrophysiology, endovascular surgery, minimally invasive cardiac surgery, and laparoscopic vascular surgery are all fields of application. Robotic devices enable endoscopic reconstructive surgery in narrow spaces and fast, very precise placement of catheters and devices in catheter-based interventions. In all robotic systems, the operator manipulates the robotic arms from a control station or console. In the field of cardiac surgery, mitral valve repair, CABG surgery, atrial septal defect repair, and myxoma resection can be achieved using robotic technology. Furthermore, vascular surgeons can perform a variety of robotically assisted operations to treat aortic, visceral, and peripheral artery disease. In electrophysiology, ablation procedures for atrial fibrillation can be carried out with robotic support. In the past few years, robotically assisted percutaneous coronary intervention and abdominal aortic endovascular surgery techniques have been developed. The basic feasibility and safety of robotic approaches in cardiovascular medicine has been demonstrated, but learning curves and the high costs associated with this technology have limited its widespread use. Nonetheless, increased procedural speed, accuracy, and reduced exposure to radiation and contrast agent in robotically assisted catheter-based interventions, as well as reduced surgical trauma and shortened patient recovery times after robotic cardiovascular surgery are promising achievements in the field.

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“…A wide surgical exposure is a ‘conditio sine qua non’ for en bloc removal of the tumour, including wide resection around the base to prevent recurrence. Minimally invasive myxoma resection has been successfully reported, with shorter operative times, using a surgical robotic system 74 75…”

Section: Therapy Of Cardiac Tumoursmentioning

confidence: 99%